Spectrum of Care: Medical and Dental Benefits and Services
The Canadian Forces (CF) Spectrum of Care document was first published on 21 December 1998 to describe the health benefits and services available and publicly funded for CF members and other eligible persons. It is published by the Surgeon General under the authority of Chief Military Personnel (CMP) and is updated regularly.
The CF Spectrum of Care document provides direction to CF health care providers, Base/Wing Surgeons, Dental Detachment Commanders, CF chain of command and CF members. It authorizes the use of public funds to ensure that CF members have access to a standard of health services that is comparable overall to that received by Canadians under provincial health care plans. Inclusions and exclusions apply everywhere in Canada and abroad, regardless of what health services are covered by provincial or allied health plans. The Spectrum of Care’s primary focus is not on equity with the provinces, but rather on operational benefit: i.e having the right person available for operations with the right level of health fitness.
The Spectrum of Care Committee must represent CF operational needs and is chaired by Assistant CMP with representation from all three Environments. Its recommendations must be endorsed by CMP, presented at least annually or as required to Armed Forces Council (AFC) and Program Management Board (PMB), and may result in Memoranda to Cabinet if necessary to ensure that resources are allocated to support Spectrum of Care decisions.
Decisions to include or exclude a health service are based upon the following five principles:
- the treatment, service, or item adheres to the scientific principle of evidence based medicine; this principle would eliminate any new medical procedures or remedies that have not been adequately investigated and scientifically found to provide a significant health benefit (e.g. homeopathic remedies);
- the treatment, service, or item is necessary for the purpose of maintaining health and mental well-being or preventing disease; it permits the diagnosis or treatment of an injury, illness or disability;
- the treatment, service, or item is not for purely experimental, research or cosmetic purposes;
- the treatment, service, or item is funded by at least one province or federal agency; this principle is in keeping with Public Service Health Care Plan (PSHCP) criteria; and
- the benefit sustains or restores a serving member to an operationally effective and deployable status.
Requests for amendments, additions, or deletions of health services must be addressed through the CF Health Services chain of command to Director Medical Policy or Director Dental Services as applicable.
The Spectrum of Care document consists of guidelines that are regularly updated in response to changes in technologies and in provincial health care plans. It does not constitute a list of rights, and the final decision as to whether or not a service is provided, approved, and/or funded for a specific CF member is made by the applicable senior medical or dental authority.
Commander CF Health Services Group
(Reviewed May 2013)
The Constitution Act places responsibility upon the Federal Government for providing medical care to members of the Canadian Forces (CF). This is because the Canada Health Act and the provincial health insurance acts exclude members of the CF from the list of "insured persons" for the purpose of provincial health care coverage. Therefore, the CF provides its members with comprehensive health care comparable to that guaranteed to all Canadian citizens under the Canada Health Act.
The Canada Health Act of 1 April 1984, which applies to all Canadians, states that: "....the primary objective of Canadian health care policy is to protect and restore the physical and mental well-being of the residents of Canada and to facilitate reasonable access to health services without financial or other barriers." the Act further states that insured person means: "....a resident of the province other than a member of the Canadian Forces."
On behalf of the Department of National Defence (DND) and CF, Commanders are responsible to ensure that the health services requirements of CF members and eligible persons are met. The Commander CF Health Services Group (H Svcs Gp) will develop and maintain an organizational structure to assist CF health care personnel and enable Commanders, within the chain of Command, to fulfill their responsibilities for the provision of health care to entitled members.
NPN: National Provider Network. A national network of civilian medical care providers (individuals or facilities) contracted to assist in the delivery of in-garrison medical care to eligible persons when CF Health Services (CF H Svcs) resources are not available.
HCC: Health Care Coordinator. The HCC is the Senior Medical Authority on each CF Base/Wing, who is responsible for the management of in-garrison medical services provided to the military population in their designated area of responsibility.
Certified Civilian Health Practitioner: A civilian who is registered, licensed or certified to provide health services within the province in which care is provided; and
Certified Military Health Practitioner: A military health care provider, who is registered, licensed or certified to provide health services within a province of Canada.
CPA: Contracted Plan Administrator. The CPA is the civilian agency that has been contracted to administer the NPN. The CPA assists the HCC in ensuring health services are available to all eligible persons.
Medical/Dental Local Authority: A Medical or Dental senior health professional on each Base/Wing, who has the authority to approve health services provided by the CF.
Clinical Specialist: Physician, surgeon or dentist, who has specialized training in medicine or dentistry exceeding the level of training acquired by a general practitioner or dentist.
Attending Physician: A military or civilian physician, who usually sees the patient.